When it comes down to it, CoxHealth has little choice but to grow.
Aging baby boomers are a huge segment of the population and will need increasing levels of health care – and the regional health system wants to be ready.
“A lot of the growth in health care is demographic,” says Jake McWay, CoxHealth chief financial officer. “The aging of the population is just driving more and more use, which is a blessing if you’re just purely looking at it like, ‘My industry is growing,’ but it’s also a problem if you look at (as) how much we’re spending as a nation. There’s only so much of the economy that can be spent on health care before it starts hurting everything else.”
CoxHealth posted 2011 revenues of roughly $2.26 billion, up 10 percent from 2010, and 16 percent higher than in 2009.
In January, Steve Edwards became the health system’s fifth CEO since 1965. He and other CoxHealth officials keep close tabs on community needs as well as national data, responding to what they learn.
“We do a needs assessment on a periodic basis as part of our strategic planning process,” says Dr. John Duff, senior vice president and chief hospital officer. “As a result of that needs assessment, we forecast about five years ago that we would need continued expansion of our facilities to include new (emergency department) and new surgical capacity.
“We brought the state-of-the-art emergency department online. We also brought online a very unique orthopedic center, combined orthopedic surgical care with rehabilitation and skilled nursing capacity, as well as the physicians all located in the same area.”
Duff says the organization also has been realigned to allow for growth. Its administration, for example, has been streamlined, with Edwards’ previous position – chief operating officer – eliminated and others redefined. Also, hospital and home health are now under the leadership of one person, which helps provide continuity of care for patients leaving the hospital and returning to their homes.
And in another forward-thinking move, CoxHealth is becoming more entwined with Cox College as it trains health care professionals.
“Being more tightly linked to our college, we also will be in a better position to be sure we have the work force we need going forward,” Duff says.
Having a highly skilled nursing force is crucial, McWay says, noting that medical schools simply can’t keep up with the demand for physicians, so nurse practitioners and physician’s assistants will have to step up more to help meet the needs of patients.
“There’s no way there will be enough physicians there to take care of everybody,” McWay says. “The schools can’t keep up.”
And, of course, all of these increased demands are coming at a time when health care funding is squeezed.
“You’ve got the state, which has a big hole in the budget again this year and is going to take a big chunk out of Medicaid,” McWay says. “The rate of inflation may be slowing down, but government pay is going down. Because the commercial side of the equation — businesses, employers, insurance companies — are more squeezed, they can’t just pick up the tab … so there really is no way to turn other than deliver more care in a more efficient way.”
That’s where technological advances enter the picture.
“There’s a steady march across all service lines toward, ‘Can you do more and more in an outpatient setting?’ What we see projected is modest growth for inpatient services, but really strong growth for outpatient care,” McWay says.
CoxHealth administrators say they simply have to stay flexible and keep looking ahead to meet increased demand at a time when health care funding is diminished and health care regulation has thrown everything into a state of flux.
“The fact of the matter is, we cannot afford to stay on the same path we’ve been on as a country, so we have to be evolving the way care is delivered,” McWay says.
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